Daniel Budman, MD, not only has extensive experience treating cancer patients, but also with searching for solutions in the laboratory.
He is a principal investigator for the National Cancer Institute-sponsored Cancer and Leukemia Group B (CALGB) research group, which brings together clinical oncologists and laboratory investigators to develop better treatments for cancer. In this arena, Dr. Budman was responsible for introducing new agents into CALGB breast cancer trials.
As he develops the new partnership between the North Shore-LIJ Health System and Cold Spring Harbor Laboratory, Dr. Budman continues to bring together the complementary work of physicians and researchers. In this new Leadership Series installment, he discusses how the partnership can help give cancer patients quicker access to more breakthrough treatments. See video highlights of Dr. Budman's discussion below.
Question from interviewer: You recently assumed a new role as North Shore-LIJ’s director of translational research for hematology and medical oncology and you will be playing a key role in developing the health system’s alliance with the Cold Spring Harbor Laboratory. Tell me about that.
Dr. Budman: This is a wonderful opportunity for Cold Spring Harbor Laboratory and North Shore-LIJ Health System to meld efforts. We’re combining the efforts of a premiere health system with a world-class research institution. This will increase efforts to understand and treat diseases and, hopefully, prevent them. This could be game-changing.
Q: Explain how the partnership will be managed.
Dr. Budman: I have a background in both laboratory and clinical science. My major goal will be doing transitional work; melding the doctors with the PhD researchers. Historically they’ve operated in silos and there’s very little interchange between the two. We want to enhance that interchange so that the people doing [laboratory] research understand physicians’ problems and vice versa.
It will be educational for both sides. The research side will get to see what happens on the hospital floor and the doctors will get to see what happens in the research lab.
Q: This affiliation is part of a broader initiative to enhance North Shore-LIJ’s cancer services. Can you elaborate on the initiatives the Cancer Institute has undertaken and what successes have you had?
Dr. Budman: We’ve been working with the National Cancer Institute through research grants for many years, mainly dealing with clinical research. We have many people in the Cancer Institute who are well-versed in clinical research and translational research. What this allows us to do is amplify that to the next level.
Cancer, unfortunately, is still a major problem worldwide. In fact, the World Health Organization has indicated that by 2020 cancer will be the number one diagnosis around the world. We haven’t solved the problem. We’ve made inroads, treatments are better, but the problem is still there. [The Cold Spring Harbor Laboratory] has made basic biologic findings that totally revolutionize much of biology; and now we can meld that with clinical problems.
National Cancer Institute Programs
Q: Tell me about North Shore-LIJ’s work with the National Cancer Institute and some of its community oncology programs.
Dr. Budman: We have elevated cancer care on Long Island. As examples, we’ve been involved at the ground level in changing breast cancer treatment. We’ve been involved in changing leukemia treatment and in fact, we have one of the largest acute leukemia centers in the country. In addition to that, we’ve been involved in molecular biology studies nationally, which has also changed how people look at these diseases.
Q: What are some ideas or advantages that will come out of the Cold Spring Harbor Laboratory relationship?
Dr. Budman: The power of Cold Spring Harbor Laboratory is tremendous. [Its work allows] not only drug development, but potentially diagnostic [development]. We now understand that cancers are heterogeneous, they have many different properties. There will be work done to allow us to better understand the disease and hopefully, better treat the disease. There will be work done on pathogenesis of the disease and on the diagnostic characteristics of tumors.
Q: Is there physician training that you can do in conjunction with Cold Spring Harbor Laboratory?
Dr. Budman: We want to set up a training track for a research fellowship in oncology. It’ll be a MD who spends a year clinically seeing oncology patients and then spends two or three years at Cold Spring Harbor Laboratory learning the molecular biology. After that the fellow would hopefully come back here to work.
Cancer in the Crosshairs
Q: You’ve dedicated your 35-year career to cancer research. What have been the most significant developments and what would you expect to see in the next five to ten years?
Dr. Budman: There’s an explosion in development based on genomics. We now have a better idea of who’s susceptible to disease and how a patient will react to a drug. The genomics of the tumor itself many times tells us what drug is appropriate.
In the short run, genomics is going to be very important. In the long run, it’s going to actually encompass a lot more because genomics is going to be important in hypertension, in cardiovascular disease, diabetes, senility and more. The whole area is exploding. We’re fortunate to [work with] Cold Spring Harbor Laboratory, which is at the forefront of genomics.
The other area that is developing quickly is computer-aided drug design. This was first seen with AIDS drugs and now we are seeing it with cancer drugs.
Q: What significant developments do you expect to see in the years ahead?
Dr. Budman: What’s been recently exploding over the last two years is harnessing the body’s immune system to fight tumors. This has been an area where people have tried immunotherapy for almost a hundred years without success. But now, with new developments and new understanding, we can actually treat tumors using the body. That’s going to be particularly important.
Other areas that are going to be particularly important are better understanding of why tumors mutate. We know that if tumors mutate, they can become resistant. If we can prevent that mutation, we’re going to have a step up on how to treat those tumors.
Q: What would you say to young physicians who were interested in research?
Dr. Budman: It’s a wonderful time. The understanding of molecular biology is advancing. I look back over my own career and it’s changed so rapidly. We did things manually and now you can do things by machine in large quantities. You have statisticians who can analyze huge quantities of data where we would just look at four or five samples. It’s changing very rapidly and for the better.